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Treatment of cytomegalovirus anterior segment infection with intravitreal injection of ganciclovir in adjunction with or without oral valganciclovir: a long-term results.
- Source :
-
Scientific reports [Sci Rep] 2021 Feb 04; Vol. 11 (1), pp. 3105. Date of Electronic Publication: 2021 Feb 04. - Publication Year :
- 2021
-
Abstract
- We evaluated the therapeutic outcome of intravitreal injection (IVI) of ganciclovir with/without oral valganciclovir for cytomegalovirus (CMV) anterior segment infection. We enrolled 61 patients (61 eyes) with PCR-proven CMV anterior segment infection. IVI of ganciclovir (2 mg/0.05 mL) was given as a loading dose; subsequent use of oral valganciclovir (900 mg twice daily) was determined according to the severity of anterior chamber inflammation after injection. All eyes had IVI of ganciclovir, and 53 patients received oral valganciclovir as adjunctive therapy with a mean duration of 1.9 months to achieve disease remission. Repeated diagnostic aqueous taps were performed in 37 eyes with suspected recurrence, and CMV DNA was positive in 24 eyes. This therapeutic strategy afforded a median 50% recurrence-free survival time of 47.0ā±ā8.12 months. The patients' mean best corrected visual acuity, intraocular pressure and corneal endothelial cell counts stabilized or improved. Corneal transplantation before CMV infection diagnosis was identified as an independent risk factor for recurrence (hazard ratio 6.81, 95% confidence interval 1.21-38.23, Pā=ā0.029). In patients with CMV anterior segment infection, the relative short-term therapeutic strategy, IVI of ganciclovir in adjunction with/without oral valganciclovir, effectively achieved a median recurrence-free survival time of nearly 4 years.
- Subjects :
- Administration, Oral
Adult
Aged
Anterior Chamber drug effects
Anterior Chamber pathology
Anterior Chamber surgery
Anterior Chamber virology
Antiviral Agents therapeutic use
Cornea drug effects
Cornea pathology
Cornea surgery
Cornea virology
Corneal Edema pathology
Corneal Edema surgery
Corneal Edema virology
Corneal Transplantation adverse effects
Cytomegalovirus growth & development
Cytomegalovirus pathogenicity
Cytomegalovirus Infections pathology
Cytomegalovirus Infections surgery
Cytomegalovirus Infections virology
DNA, Viral antagonists & inhibitors
DNA, Viral genetics
Drug Administration Schedule
Female
Humans
Intraocular Pressure drug effects
Intravitreal Injections
Male
Middle Aged
Pseudophakia pathology
Pseudophakia surgery
Pseudophakia virology
Recurrence
Retrospective Studies
Risk Factors
Treatment Outcome
Visual Acuity drug effects
Corneal Edema drug therapy
Cytomegalovirus drug effects
Cytomegalovirus Infections drug therapy
Ganciclovir therapeutic use
Pseudophakia drug therapy
Valganciclovir therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 2045-2322
- Volume :
- 11
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Scientific reports
- Publication Type :
- Academic Journal
- Accession number :
- 33542372
- Full Text :
- https://doi.org/10.1038/s41598-021-82637-y